P1192METABOLIC SYNDROME IN PATIENTS UNDERGOING PERITONEAL DIALYSIS (PD): A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Oto Di Gruttola ◽  
Giuseppe Paribello ◽  
Immacolata Gaia Paduano ◽  
Silvia Migliaccio ◽  
Gennaro Argentino ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Waist Circumference ◽  
Pharmacological Treatment ◽  
Negative Impact ◽  
Individual Risk ◽  
Individual Risk Factor ◽  
High Waist Circumference ◽  
Single Center Experience ◽  
Replacement Treatment

Abstract Background and Aims Metabolic syndrome (MS) is a set of alterations represents a cluster of risk factors that increase the probability of causing cardiovascular (CV) events by three times. The aim of our study was to analyze the prevalence of MS in patients with Chronic Renal Failure undergoing replacement treatment by peritoneal dialysis afferent to our center. Method We retrospectively studied 117 patients in PD (2015-2019 census period). The characteristics are reassumed in tab1. We assessed the prevalence and impact of MS considering hard outcome: death for IMA and cerebral death. Patients with at least 3 of the following diagnostic criteria (CD) were considered affected by MS: waist circumference> 102 cm in men or > 88 cm in women, high blood pressure (PA> 130/85 mmHg or under pharmacological treatment), HDL levels <40 mg/dl in men or <50 mg/dl in women, triglycerides> 150 mg/dl and fasting glucose> 100 mg/dl or under pharmacological treatment. Results The prevalence of MS in our cohort is 46% (54 patients), the patients who have 2 CD are 29% (34 patients), those with only 1 CD 25% (29 patients), no patient had 0 CD. Arterial hypertension represents the most represented risk factor (RF) (91.1%) in agreement with the literature and with the Framingham Offspring Study (non-dialysis patients). The others RF are distributed in this way: reduced HDL (55.8%), hypertriglyceridemia (40.2%), high waist circumference (38.2%), fasting hyperglycaemia (24.5%) (graph 1). Among the 54 patients with MS, 12 CV events occurred during the observation period, while among the 34 patients with two CD, 8 CV events occurred. Among the 29 patients with only 1 CD there was 1 death attributable to CV causes (graph 2). From these data it is clear that MS is a risk factor for CV events according to the literature. It is interesting to observe that comparing the group of patients with 2 CD and with 1 CD, it shows that the presence of 2 CD is a sufficient risk factor to increase the probability of CV events (OR = 8.6 & p <0.05 ). Conclusion The prevalence of MS in patients receiving peritoneal dialysis is elevated with a negative impact on the risk of CV events. At the same time, our data shows the importance of assessing each individual risk factor regardless of the presence of full-blown MS. In particular, we observed that the presence of 2 CD is sufficient to predispose CV events. This shows that timely treatment of RF, even in the absence of full-blown MS, could favor the reduction of the risk of CV events in patients in DP

scholarly journals A comparison of lobectomy and total thyroidectomy in patients with papillary thyroid microcarcinoma: a retrospective individual risk factor-matched cohort study

2017 ◽  
Vol 176 (4) ◽  
pp. 371-378 ◽  
Author(s):  
Hyemi Kwon ◽  
Min Ji Jeon ◽  
Won Gu Kim ◽  
Suyeon Park ◽  
Mijin Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Microcarcinoma ◽  
Individual Risk ◽  
Matched Cohort ◽  
Papillary Thyroid ◽  
Individual Risk Factor ◽  
Matched Cohort Study ◽  
Thyroid Microcarcinoma

Objective Papillary thyroid microcarcinoma (PTMC) accounts for most of the increase in thyroid cancer in recent decades. We compared clinical outcomes and surgical complications of lobectomy and total thyroidectomy (TT) in PTMC patients. Design and methods In this retrospective individual risk factor-matched cohort study, 2031 patients with PTMC were initially included. Patients who underwent lobectomy or TT were one-to-one matched according to individual risk factors, including age, sex, primary tumor size, extrathyroidal extension, multifocality and cervical lymph node (LN) metastasis. Results In total, 688 patients were assigned to each group. During the median 8.5 years of follow-up, 26 patients (3.8%) in the lobectomy group and 11 patients (1.6%) in the TT group had recurrences. The relative risk of recurrence was significantly less in the TT than that in the lobectomy group (hazard ratio (HR) 0.41; 95% confidence interval (CI) 0.21–0.81; P = 0.01). Most recurrences (84.6%) in the lobectomy group occurred in the contralateral lobe, and all patients were disease-free after completion of thyroidectomy. There were no significant differences in recurrence-free survival between the two groups after exclusion of contralateral lobe recurrences (HR, 2.75; 95% CI, 0.08–8.79; P = 0.08). There were significantly more patients with transient and permanent hypoparathyroidism in the TT than that in the lobectomy group (P < 0.001). Conclusions Lobectomy could be appropriate for most patients with PTMC when there is no evidence of extrathyroidal disease in the preoperative work-up. Preoperative and postoperative imaging studies are important for patients who undergo lobectomy for PTMC, because most recurrences are in the contralateral lobe.

scholarly journals The Effect of Ethnicity on Preterm Birth and its Influence on the Risk Factors for Prematurity

2019 ◽  
pp. 180-192
Author(s):  
P Bachkangi ◽  
AH Taylor ◽  
JC Konje
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Birth ◽  
High Risk ◽  
Risk Groups ◽  
Individual Risk ◽  
Individual Risk Factor ◽  
Increased Risk ◽  
Gestational Age At Delivery ◽  
Very High

Preterm birth (PTB) affects 9.6% of pregnancies worldwide and is associated with a very high perinatal mortality that depends on the gestational age at delivery. As a result, PTB has a significant health and financial impact on health systems, families and societies. Its aetiology is not fully understood, but in most cases it is multifactorial, with several maternal, paternal, and epidemiological factors associated with increased risk. Other factors include parental ethnicity, maternal age and body mass index, socioeconomic status, and where the families live. This review examines the influence of ethnicity as an individual risk factor for PTB. It also explores its influence on the epidemiology of PTB and demonstrates that data on certain ethnicities are lacking, despite the fact that these ethnic clusters are within the very ‘high-risk groups’ that are adequately represented in some Western societies. This review examines the influence of ethnicity as an individual risk factor for PTB and also explores its influence on the different epidemiological aspects. A thorough revisit of the ethnic epidemiology unveiled other unnoticed risk factors that if addressed appropriately prematurity can be prevented. Moreover, certain ethnicities were not within the attention of researchers, despite the facts that they are very ‘high-risk groups’ and are also adequately represented in some Western societies.

scholarly journals Chronic Obstructive Pulmonary Disease (COPD) as a Risk Factor for Glucose Metabolism Perturbation and Insulin Resistance

2007 ◽  
Vol 30 (3) ◽  
pp. 29
Author(s):  
M. Doucet ◽  
L. Laviolette ◽  
D. Gagné-Belley ◽  
F. Maltais
Keyword(s):  
Insulin Resistance ◽  
Risk Factor ◽  
Waist Circumference ◽  
Glucose Metabolism ◽  
Fasting Glucose ◽  
Homa Index ◽  
Blood Samples ◽  
High Waist Circumference ◽  
Control Subjects ◽  
Copd Patients

Background: High body mass index (BMI) is associated with better survival in COPD. However, increased BMI and especially waist circumference is associated with elevated pro-inflammatory systemic markers that might contribute to glucose intolerance. On the other hand, COPD is a chronic inflammatory disease that could be a risk factor for impaired glucose metabolism. The objective of this study was to compare the prevalence of glucose intolerance in COPD patients and control subjects with high waist circumference. Methods: Eleven patients with COPD (age:68±8 yr mean±SD; FEV1:49±17% pred) and 10 control subjects (C) (age:63±6 yr) underwent a 75g oral glucose tolerance test (OGTT). All subjects had a waist circumference >102cm and no previous history of diabetes. Height and weight were measured and each subject underwent dual-energy X-ray absorptiometry (DEXA) to evaluate fat-free mass (FFM) and fat mass (FM) and abdominal tomography to evaluate visceral fat (VF). Blood samples were taken to measure inflammatory markers (C-reactive protein (CRP), tumor necrosis factor (TNF), interleukin (IL)-6). Venous blood samples of glucose and insulin were taken while fasting and during OGTT. Insulin resistance was estimated with the fasting homeostasis model assessment (HOMA) index. Results: FM, FFM and VF were not different between groups. Diabetes was diagnosed in two subjects in both groups (2hr post OGTT glucose ≥11.1 mmol/l). Four COPD and 1 C had impaired fasting glucose (fasting glucose 5.6–6.9 mmol/l) while 1 COPD and 2 C had impaired glucose tolerance (2hr post OGTT glucose 7.8–11.1 mmol/l). In COPD patients a negative correlation was found between the HOMA index and FEV1 (r2:0.52, P < 0.05). Conclusions: COPD subjects with high waist circumference are similar to control subjects in term of FFM and FM, level of systemic inflammation and response to OGTT. In COPD, the severity of the disease is associated with an insulin resistance that may potentiate the risk for the development of type 2 diabetes in these patients.

scholarly journals Contribution of Individual Risk Factor Changes to Reductions in Population Absolute Cardiovascular Risk

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Cochrane ◽  
Rachel Davey ◽  
Christopher Gidlow ◽  
Zafar Iqbal ◽  
Jagdish Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
High Blood Pressure ◽  
Individual Risk ◽  
High Cholesterol ◽  
Cvd Risk ◽  
Individual Risk Factor ◽  
One Year ◽  
Individual Risk Factors

Background. Few studies have investigated individual risk factor contributions to absolute cardiovascular disease (CVD) risk. Even fewer have examined changes in individual risk factors as components of overall modifiable risk change following a CVD prevention intervention.Design. Longitudinal study of population CVD risk factor changes following a health screening and enhanced support programme.Methods. The contribution of individual risk factors to the estimated absolute CVD risk in a population of high risk patients identified from general practice records was evaluated. Further, the proportion of the modifiable risk attributable to each factor that was removed following one year of enhanced support was estimated.Results. Mean age of patients (533 males, 68 females) was 63.7 (6.4) years. High cholesterol (57%) was most prevalent, followed by smoking (53%) and high blood pressure (26%). Smoking (57%) made the greatest contribution to the modifiable population CVD risk, followed by raised blood pressure (26%) and raised cholesterol (17%). After one year of enhanced support, the modifiable population risk attributed to smoking (56%), high blood pressure (68%), and high cholesterol (53%) was removed.Conclusion. Approximately 59% of the modifiable risk attributable to the combination of high blood pressure, high cholesterol, and current smoking was removed after intervention.

scholarly journals Waist Circumference Is Not Associated with Impaired Fasting Blood Glucose in a Sample of Mexican Children and Teenagers: Results from a State Screening Program

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 172
Author(s):  
Edtna Jáuregui-Ulloa ◽  
Alejandro Gaytán-González ◽  
Mayra Elizalde-Villarreal ◽  
Esmeralda González-Navarro ◽  
Alberto Ocampo-Chavarría ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Quantile Regression ◽  
Screening Program ◽  
Fasting Blood Glucose ◽  
Age Group ◽  
High Waist Circumference ◽  
Mexican Children

A high waist circumference (WC) is used as a risk factor for impaired fasting blood glucose (IFG) in adults. This association is less studied in children and teenagers. The purpose of this study was to analyze the association between having a high WC and IFG by sex and age in a sample of Mexican children and teenagers. We analyzed the data of 12979 participants aged 5 to 17 years to calculate percentile references for uncorrected WC, corrected for height (WC/HT) and by height squared (WC/HT2) with quantile regression. A subsample of 2309 participants with fasting blood glucose samples (FBG), WC, WC/HT and WC/HT2 values was analyzed with logistic regression. A high WC, WC/HT, and WC/HT2 were considered at the sex- and age-specific 90th percentile from the subsample. The IFG was considered as FBG ≥100 mg/dL. Having a high WC, WC/HT, nor WC/HT2 was not significantly associated with IFG for either sex and age group (all p > 0.05). A high WC, either on its uncorrected or corrected for height values, was not an important assessment for predicting IFG in a sample of Mexican children and teenagers. This study provides percentile reference values specific for sex and age.

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